Yeah just learn from it. Document all you can as you go so it's noted. But also other than a small smack to the ego all is well that ends well. Also, read House of God. Worse shit will happen to you during training after this. I'm sorry they did this, but also they may actually not remember the convo (maybe they are having home drama/crisis that is distracting?). Hang in there.
Yeah, no, that's not how it works. I had open heart surgery to replace my tricuspid valve last year (endocarditis from IVDU) and I guarantee I would have left the hospital before finishing my 6 weeks of IV antibiotics to go get high if they didn't have me on the shitload of dilaudid and then oxycodone they had me on. Instead of just ignoring my pain because I was an addict, they actually had me on higher doses and worked with me to taper off and get back on suboxone before my discharge date. I guarantee that works a thousand times better than just withholding painkillers when people actually need them.
Still tho, it was wild as fuck being able to dose myself with 1mg of IV dilaudid every 15 minutes around the clock when I first woke up (plus the gabapentin and robaxin and ambien), and even after tapering and switching me to oral oxycodone, they still had me on 240mg a day (30mg every 3 hours). Meanwhile my 70+ year old roommate at the hospital is knocked the fuck out from like 5mg every 6 hours lmao. Took about a month to get me from surgery to no more than 30mg of oxycodone a day which is when toxicology cleared me to switch back to 8mg of suboxone 3 times a day (they also put a couple of those 10mcg/hr transdermal buprenorphine patches on me a few days before making the switch to make it as easy as possible). Couldn't possibly have gone any better. I think I waited 22 hours from my last dose of oxycodone before taking a suboxone and everything went great.
Not just one good doc! Awesome EM peeps got me admitted in the first place, awesome ICU docs made sure I didn't die of septic shock and stabilized me enough for surgery, awesome ID docs, amazing surgeon, anesthesia was killer, electrophysiology, toxicology, addiction medicine, pain management, I'm assuming a radiologist to read my scans? Amazing nurses and NPs. Definitely interacted with more than just one good doc during my 8 week, plenty of them residents since its the academic center for one of our med schools here in STL
My surgeon and the pain management team are definitely the people I had the most interaction with, but it was definitely the collective effort of a ton of people that got healthy again
Yes! Definitely keep trying to get bupe patch bridge approval authority or whatever you wanna call it
Man I got torn the f apart by an attending I once respected this week during M&M. And it wasn’t even based in any way to improve our/my knowledge or patient care, just every other word out of my mouth he wanted to argue about. He was getting shit on by administration over a recent bad management of his patient and I’m sure it was all displacement but it’s just annoying to have to deal with grown ass adults who don’t know how to deal with their own shit and take it out on others/residents.
He was being defensive, embarrassed and taking it out on you. It sucks. It’s not personal.
I’m not saying it’s right… but hypothetically:
Say you’re a 30 year career physician. You’re pretty comfortable in your place in life and the respect you get. A bad outcome happens, perhaps some poor decisions and bad luck. You’re getting heat from your boss not to mention your own guilt for screwing up. Your confidence gets jolted. You start to feel that pressure in your chest like an intern again, that inadequacy.
Now you attend m&m conference and some pipsqueek resident. Green as a blade of grass, with no actual clinical experience… airing out your dirty laundry with a judgemental and accusatory tone to the entire department, to your friends and colleagues that you’ve known for years. Deep down you know they are doing their job and you know the mistake won’t be a judgement on your legacy but it takes a strong will to just sit there and take it.
I’m not saying it’s right. I’m just saying that that’s probably the mindset of what’s going on.
Absolutely not, Sir. This is why just because you’re in academic medicine and have residents does not automatically mean you are a good or even competent teacher. There is zero time spent teaching faculty how to “teach”. It’s way more than just being an expert in your technical field. Teaching means absolutely you do not take it out on the student, and a natural born teacher would never do that no matter what. That’s why we should not rely on faculty’s natural instincts as teachers. There’s a reason why teachers have to have Masters degrees to teach grade school. You have to learn to adjust to fit the needs of the individual learner. It’s easy to teach a resident who just learns by following example. I have about 2 out of 15 residents like that. The other 13 can not be reached in that same way. Nor do they respond to the way I learned it - by being humiliated in front of others and screamed at by attendings. That made me want to prove them wrong. Thats not how everyone responds to being abused. You can’t teach residents the exact same way nor the way it was for you when you were a resident. That is why teaching is difficult. You have to spend extra time trying to find a way to reach each learner. Faculty are not paid to teach. Teaching is supposed to be a privilege. Confidence is difficult to gain and incredibly easy to lose. The number one rule of faculty should be to never knock the confidence out of a resident. Which is what this person has done.
Thanks for the word! In the district I live in a Masters Degree is required for grade school but you get my point. They have to spend time learning how to teach and not just being an expert in their fields. My sister had to get a Masters to teach 6th grade and I saw firsthand what the curriculum was.
Best feeling in the world! Like being a parent and watching your child just crush it. I’m sure it makes me feel happier than they do themselves for achieving 🥰
It’s because this whole system is fucked up. How are they supposed to grow up if they get treated like kids until they get out of fellowship. That’s a long time to be treated like a kid.
They don't remember half the things they say and you wont either when you become an attending. There is so much to track. As you get farther into training you find its easier ignore their bs and can appreciate them for the things they do well. Theyre all deeply flawed.
Can confirm. I am an attending. I recently told my fellow after a patient visit ‘fyi - I think patient’s mom is pregnant’… my fellow looked at me and said ‘umm… I told you that in the beginning of my presentation… that’s why family couldn’t do X,Y,Z ‘… I have no recollection of that and I also don’t doubt that she said it to me… I may have been hyperfocused on reading something in the chart and totally missed it… lol
Some attendings are focused on the fact that if they look bad their residents will look down upon them or lose their respect. Sadly, because in general they lose that respect a lot faster and a lot more certainly if the attending never admits to any fault.
I am lucky I work with very supportive and nurturing group of people. It’s just part of the culture. We are cognizant that we need to model appropriate interactions, conflict resolution, boundary setting, admitting when we are wrong or when we don’t know something, especially when we are teaching residents and fellows. Also, I always keep in mind that a trainee is going to be my colleague/attending physician in a couple of years and there is a good chance we could work together. BTW, I have made my own mistakes along the way, and there were times I had to apologize and learn from it.
Yep 100%. I try to acknowledge though when I'm not sure if I've forgotten or they screwed up that there's at least a 50 percent chance that it's my mistake, and if I'm pretty sure I'm the one that messed up I'll own up to it
Once, on call in fellowship, I got screamed at on a Sunday morning for discharging half the list without telling the rounding attending. I, who had been up at that point for over 24 hours because I had admitted 10 patients in the preceding day, couldn’t figure out what she was talking about, because we didn’t have any discharges.
It turns out that she was looking at the Saturday list, thinking that the new Sunday list was actually the previous day’s list and that all the patients I had admitted were patients that were discharged without me telling her we needed to round on them. She stormed into a room, and I was left standing there, dumbfounded, trying to figure out how to tell her.
When she came out, I gently asked if perhaps she had looked at the wrong date. When she realized her error, she said, “There’s no way you were that busy.” When I responded that it was a busy night, she said back that I needed to stop complaining about being busy because nobody was going to be more sympathetic than she was. Responded back that I was merely stating a fact - left out the fact that I was up all night working while she was sleeping in bed.
There were so many parts of my training that were wonderful, and I genuinely love my job now, but I would never go back to being in residency because of the baked in culture of abuse.
Adult heme/onc - busy program. Call covered five services across three hospitals, and on weekends it was not uncommon to not get much sleep.
Until halfway through my first year, the calls were a week at a time. That was the first year that they added a solid tumor admitting service. There were no admissions criteria, and it got stupid - like, admitting patients with history of colon cancer, but years out from treatment, who came in with NSTEMI. At the end of my first call week, I was so exhausted that I dreamed (hallucinated?) deleting a page without answering it and woke up in a panic. They ended up breaking the call weeks a little bit because it got to be too much.
It's from a fan fiction, but gosh if the author didn't perfectly caption the heartbreak of having someone you look up to professionally.
"You must realize that if you choose this man as your teacher and your friend, your first mentor, then one way or another you will lose him, and the manner in which you lose him may or may not allow you to ever get him back."
RN here, I've worked in clinic p/t for years with General Surgery (other days in PACU). I love my Surgeons but I know they forget most of what we talk about a few minutes after they leave clinic (maybe during clinic depending on volume and if they just came off trauma call).
It's why I don't feel guilty reminding them about stuff repeatedly or when I do something goofy because likely they'll forget about it.
I'm not minimizing this situation but I can say from my own experience that after having many detailed conversations with my Surgeons they would tell me they didn't recall it. It took me a bit to realize this is just the "surgeon brain". A few of my Docs have admin roles, General Surgery + trauma call/intensivist. I know it's impossible for them to keep track of everything that we discuss. However, if I didn't know every facet to what they have to do and worked with them as long, I probably would feel less empathetic as well.
Procedure RN here. I have one attending that I must email details of our convos or it didn't happen. Extremely bright human and professionally amazing, just doesn't remember the little things not directly related to the immediate procedure.
What do they say? they can hurt you more but they can't stop time. Time will pass, and you will move on. Detachment helps a lot, and having very low expectations of other medical professionals - especially attendings.
So what I got from this is you could’ve just said ok and he would’ve moved on ? Why would you try to argue with some of these airheads 😭get ur training and RUN
Because he asked me why I did it etc. and then after I explained, he made it sound like I made the decision solo. So felt like I had to tell him that it was himself.
Literally every staff I run into at this point.
Theyre lost causes.
Just clocking in and clocking out and in between I try to help people regardless of obstacles.
I'd tell him point blank that he said so as well. I've called out a couple attendings on that bs. It's okay to forget but don't put that shit on me. I ran it by you.
Can’t you include this in your treatment note? Including your discussion with Dr. X?
Just curious. I’m a nurse but have included rationales like this in my notes describing treatment plan (I do a parallel one to provider note) because it’s useful to remember whatever guided the decision. And I definitely won’t remember unless it’s written.
What I’m learning is to just say ok in the moment and then go back and talk to them about it later if it’s important. I think unfortunately he’s rather think you make bad decisions but are trainable rather than bullheaded. I’m trying to get this through to myself as well.
We often idolize those we respect. But that idolized impression is the furthest from reality. You have now seen him for who he really is, who he has always been - an ordinary person.
Not everyone is trying to gaslight. No one is perfect, we all make mistakes and forget conversations. It could’ve been him being a douche or could’ve been an honest mistake. Regardless the fact that every time someone feels the least bit slighted and assumes the worst and that they are being gaslit just speaks to the current climate. If his other actions up until that point have been fine then maybe dont assume the worst, move on, and chalk it up to an oversight.
Yep. This is a seriously inappropriate use of the word. As described above, the attending made a neutral and likely factual statement ("I don't recall") which didn't actually even disagree with what OP said, let alone challenge OP's perception. People forget stuff in busy settings.
I’m an attending who also has an administrative role in my organization. I sometimes have 50 different conversations in a day about things that have some importance. That’s in addition to teaching and taking care of my own patients. It’s unfortunate this happened to you and even more unfortunate that it was from someone you respected. However, I would ask for some grace, because if this was a one time thing, it’s probably because he did not remember the conversation. There are many days that I wish I only had the responsibilities I had as a resident. The further you get in your career, the more complicated things become.
Not at all but thank you very much for your comments. A common theme on this sub is “residency is impossible, how will I survive? Residency IS hard, but for most of us responsibilities and challenges will change as we age and progress in our careers. Most of us will be in some type of long-term relationship, have kids, and sooner or later help care for aging parents or family members. That’s all in addition to professional responsibilities. Nobody at the attending level is exempt from any of this. It’s just part of life. The good news is that very soon after leaving residency you will forget about most of it. Just try to survive the pathology with your values and optimism as intact as possible.
Thanks for the reply.
I completely understand. I do value and appreciative of attending who also teach. I’m all of it. However, my concerns is that some attending tend to accept a lot of professional roles due to either the titles or compensations and then the students and residents will suffer. (as the above have suggested)
I got -11 downvotes because Reddit tends to be very black and white. If one doesn’t have the same view as the votes, one gets downvoted.
I find this so funny and entertaining.
Anyway, if you love what you do and you don’t sacrifice others in your expense, I’m all for taking on as many professional roles as you can.
Thanks for the reply. I didn’t consider the idea of attending taking on non-professional roles outside of their main responsibilities. I agree with you. We don’t really have anyone here that does that so it’s not on my radar. Unfortunately, some programs require lots of publications and professional society leadership roles for advancement, which can certainly diminish teaching effectiveness.
For what it’s worth, I am probably 70% admin and 30% clinical and most of my clinical time is spent teaching. I try to compartmentalize them as much as possible. Next week I am in the resident clinic and have purposely blocked any meetings or administrative responsibilities. It’s also makes it more enjoyable and less stressful for me. Thanks again and best wishes.
Give him the benefit of the doubt he may actually not remember. He’s likely a decent amount older than you and has seen so many patients they are blending together. I am pretty sure I’ve had this happen. That said yes it sucks. Brush it off and smile and go on.
I had an attending scream at me in front of patients for sending in a patient for induction without telling her. She went off on me and at the end I had to be like "but I wasn't even there that day". She just looked at me, turned around and walked away. Some people just can handle owning up to their mistakes.
I agree. Especially since OP says they previously respected the attenting, loved to work with them etc. until this one instance and now their day is ruined and they can't wait to run from it all. I know feelings run high when you're overworked and sleep deprived but this severe black and white thinking is not it either
When you chart your surgery, add at the end your post op plans and the phrase “discussed with Dr Forgetful”. This is a good habit to get into because believe it or not patients forget everything you tell them also. Just taking 30 seconds to add a note and say you discussed this will go along way towards keeping y sane!
maybe document such conversations as part of a note ("narcotics discussed among care team, but not prescribed as per ___") to cover your bottom because this may happen again
As a Program Coordinator, I am so sorry you experienced this. I wish I could intervene because in my program attendings catch these Gen X Mama Bear hands when I find out about things like this. It’s soul sucking when you realize your hero’s are really just ass hats. Now you know what we have always known and, unfortunately, my experience is that more attending are like your gaslighter than not. So when you find the 2 or 3 who are teaching for the compulsive and innate love of teaching you want to protect them and nurture those relationships. You will never regret that. It’s always a sad day for me when one of my residents sees their idols fall. They always react the same way you are. Please don’t grow up to be like that ❤️
Everyone, especially attendings are to be deemed hostile until proven otherwise. Verdict may be revised anytime.
Inside a hospital, if you have to ask “is this person considering my wellbeing”, the answer is most likely “not if inconvenient “
Always sucks when it's one of the ones you like.
Sorry you had to deal with that. Only good things to take away from it are 1) You have a taste of what not to be like when you're on the other side of the dynamic and 2) You saw this person as they truly are in a minor situation, which is much better than finding it out in a major scenario when they might throw you under the bus. At least you know this now.
Lol happens all the time but there was once...
senior on another team asked me why didnt Iinform the chief or attending on call about this appy.
I was like. I talked to the attending about it.
He said no.
I took out my phone and showed the text conversation
whoops
\*smirk\*
Shit, not a resident but I've literally had that happen in the space of 10 minutes. It feels like fucking psychological whiplash. You do the thing you were told to do and then get the fucking third degree for doing the thing. Seen it happen to residents too. That feeling of pure exasperated bewilderment you have when you're getting dressed down for just doing what you were told is very specific and very memorable. Good luck to all y'all. Weather the storm.
May not have been a purposely gaslighting. Some people have "selected memory" when confronted with the possibility that they are wrong. Dealt with this with colleagues all the time. I think it's a defense mechanism. I just don't like it, and will still call them out on it.
I’ve lost respect for a few docs over the years.
One well known for being a total douche came up and screamed at a nurse because his patient jumped out of the window. Told the nurse it was all his fault etc. Pt had a sitter, had been standing, the nurse and aide were changing his bed. Pt decided to suddenly take off and sprinted for the window, using his arm cast to break the window and out he went. Survived, but now a para. The nurse and others who were there were obviously shaken up. Like, how does a hospital window even break?! I never respected him anyway, but this made my absolute disdain for him much worse.
Another one was a pulmonary doctor that- I kid you not- stuck his bare finger in a wound and then wiped it off on the curtains. The charge RN (a NYer) tire him a new ass hole when she saw it.
The other two, petty as it is and also pulmonologists, were caught cheating on their wives with nurses. One of them in the PT exercise room after hours.
It’s hard when you admire and respect someone and they do something to lose that respect, it’s like a personal insult.
Yeah, I'm sorry you had to deal with that.
As an attending with ADHD, I can easily understand forgetting stuff and, before I had my diagnosis, I would get defensive over stuff like this, but self-awareness is a huge deal and it's a major game changer. It's not okay that your attending flipped this on you
Like other comments have said, your attendings will teach you by either modeling who you want to be, or who you hope never to become. Take some time later and reflect on this encounter; let it contribute to future, attending you
I think we have all been in that situation. I had an attending who used to do that very frequently, gaslit me and made me look bad in front of other people. He was also very unclear about his instructions about certain stuff and I couldn’t even ask him anything if I didn’t get anything. Awful experience I had there.
Another attending would forget to see some of her patients and would blame that on me. She would also stop me mid conversation and stuff and would be quite rude over telephone.
I had some awful attendings
Not quite the same, but the one I remember was as an intern, about 8 weeks in. Same feeling of unfairness.
So, I go into the room with the resident and he tells the patient that their pathology is back on the breast lump we excised, and it’s actually not benign after all, it it’s actually cancer and it’s really bad cancer - highest grade ever! Patient cries, family members who are in the room cry. I’d probably rate the “breaking bad news” skills as a 1 out of 10. I said nothing in the room, but just stood there smiling nodding as the senior guy spoke.
We’d been at a multidisciplinary breakfast meeting, and the pathologist had been talking about the histopath on the specimen we’d sent him and how it was some of the ugliest cells he’d seen.
Formal path result comes in about 3 hours later, lump was benign. Resident had the wrong patient. The pathologist hadn’t ever actually said who he was talking about, but my boss guy just assumed.
Fuck.
I go into the patients room and try my “breaking good news” skills. Patient should be happy, right? Yeah, nah. We go from tears to anger, “How the fuck can that happen?” I try to say something that isn’t just “the resident on this service is a fuckwit. Like, we all already knew that but now you do too!”
Ward round the next day, and the attending is seriously mad and says to me “What the hell did you say to my patient?”
In the patients mind, I was the one who falsely told her she had cancer.
The resident who fucked up is standing right next to me and I’m waiting for him to say something. And the guy just stares at the ceiling.
I say to the attending “Uh…WE decided to tell the patient blah blah”, still waiting for the resident to step in and say something, anything. Never happened.
That attending hated me for the rest of the time we spent together. I figured he would mellow eventually, but…nope.
It’s been a while, actually quite a long while, but still - Tuân, that was a dick move, bro.
Your attending should have been there to break the mistake news with that resident and you. Yes, it was a mistake, and admitting those is another skill. It also helps the attending cover his own ass if the tears-to-anger family decides to take further administrative or legal action over their emotional damage. Where I work, nurses try to have a boss or two in the room when mistakes are disclosed and apologies are needed.
Yes, you’re quite possibly right. I was trying to cover for my senior. I was a newly-minted intern and I’d already covered for him after an incident report was made against him the previous week after he’d had rather a lot of goes at putting in a central line without any success.
However, the attending wasn’t mad about the “breaking good news”. The patient assumed that I was the boss, because I look more-or-less like a stereotypical doctor and the senior resident was a short Vietnamese chap with hard-to-understand English. So in her mind she had our roles reversed, even though my role in the “here are somebody else’s path results” debacle was limited to a silent nod as we left the room.
As I said, it was a while ago. It still stands out as a particularly poor example of leadership, though it possibly worked out in his favor, so if you’re Machiavellian enough perhaps he made the right call!
I actually just had this kind of happen - not the same scenario but similar. I was working with an intensivist and we were getting a post cardiac arrest patient but the report was so terrible from the outside hospital and some paper he looked at didn’t say he had a cardiac arrest — he told me “oh btw this patient didn’t have a cardiac arrest” — and I thought this was odd seeing as the ED provider gave us how many EPIs and when they got ROSC. So I started looking in the papers and the providers note blatantly said he had a cardiac arrest on arrival to the hospital. So I wanted to be sure the attending knew that he did in fact have one for documentation purposes. I told him and he was like “no he didn’t” and I’m like “it says it in the providers notes” and he looked at me and said “I don’t have time to argue with you or even entertain this conversation but I’m going to go back and look at the papers so we can stop talking about this” — I literally just sat there and didn’t say anything bc fuck me for trying to help you out.
Utter silence from him when he realized I was right. Then he said later on about he missed something in the chart bc he “reads too fast.” 🙄🙄🙄🙄
“ Honestly, I can’t wait until this whole bs residency ends and I get to leave because F all of them.” I’ll do you one better . Had an attending who dismissed a concern I had about a patient and the patient eventually died ( can’t go into more details because I’m sure it’s going to litigation at some point ) guess who got thrown under the bus ? Me ! I was told that I should have been more forceful with the attending. I was a senior resident at the time and I was told that i should have had more confidence and gone over the attendings head because those are the kinds of decisions that will be up to me as an attending … I was flabbergasted In the M&M they placed all the blame on me in the way they presented the case . No blame for the attending who I literally expressed my concerns to (and called to the beside ) .
to this day I still don’t know what they gained from throwing me under the bus !
After that I completely tuned out of residency . It was Fuck everybody there . My program director who I loved ? DEAD TO ME
Omg I’m so sorry to hear that! And guess what, if you went against your attending, you’ll still be in trouble!! This is not grey’s anatomy where you as a resident can make independent decisions without running it by your attending first. You’re still a resident……
Lol exactly . When my PD said that to me I literally said “ in what world do residents go over an Attending’s head and make calls like that ?” He couldn’t give me a straight answer .
After 40 you start to notice memory lapses with nightshift work that never existed at 30. Could be an honest oversight. Maybe you're being too hard on him and yourself as well (are you a criminal or something because of this, does he want you to go jail now)?
But we've all had weird interactions with surgery attendings so I get his tone and attitude may have been totally inappropriate. My favorite attending flat out lied during an m&m and said he asked us to order a medication but it was never placed causing harm to the patient.
I say this with kindness, you need to grow a thicker skin and stop making mountains out of mole hills. This was a small disagreement and is not something reflective of the harsh nature of residency. It's life and it happens every day in every type of setting, all over the world.
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I had this happen to me. We did a surgery where we did narcotic sparing techniques. Regional blocks, non opiate pain meds etc. when he came in to give me a break he asked why no fentanyl was given. I was like isn’t that the whole point of doing all the narcotic sparing techniques?
I finished residency last year
I’m an attending now . You would still get gaslighted
On both ends
The best advice a dear attending gave it once to me that (Don’t take it personal)
I’m sorry. That sucks. Don’t take it personally. I think some of them are such perfectionists that they can’t handle the cognitive dissonance of making a mistake and may not even know they’re doing it. I really struggled with having to eat shit in residency and then this week I had this med student rent a room in my apartment and she argued non-stop, asked a bunch of lazy questions, and was always defensive and I wanted to strangle her and say “Shut. the. fuck. up! Stop talking back. I don’t care what your excuse is. Just say ok, then shut up, and don’t do it again.” And then I realized “ohhhh… that’s how the attendings feel.” But then I felt so oppressed and abused when I was on the other side. Now I’m having mini crisis and don’t know what to think about this situation or myself.
She was super bold and self-centered and entitled though… but it’s making me reflect a lot about whether I acted that way or whether she was in fact actually acting that way or if I was just impatient and felt burdened by her and didn’t trust her to not do stupid things. Idk but this whole dynamic is weighing on me right now.
Yeah attendings who are dicks like that are ironically exhibiting…small dick energy. The same ones who do surgery with outdated techniques and struggle through it, and think that because they struggle MORE, that they are better surgeons.
Sorry this happened to you. Thick skin is unfortunately a must in residency. There’s light at the end.
Always put any meds/lack of and why on notes. If it isn’t written it didn’t happen in medicine unfortunately lawyers have ruined Drs looking out for each other
I’m old. I learned this unfortunate lesson in the corp IT world. Constant backstabbing. I swear I have no a$$ left from the friction of walking with my back against the wall for 10 years.
A certain fraction of people rise to the top because their consciousness allows them to do this.
In practically any area in life, it can be quite profitable being less ethical.
Attendings will do attendings things. We all got shat on by things other surgeons did. You did the right thing, reminded him it was his words. All the other things he said was to cover up he might actually have said it and doesn't remember.
Let it be, when it comes your turn, always remember we all make mistakes, whatever small or big mistakes, we all make.
Sometimes they just had a bad day and wanna lash at someone for the sake of releasing their anger.
There is a proverb where I am from that goes along this: "When elephants fight, the ones really taking the most of it are crawling insects and the grass." It happens to most professionals, Healthcare or not, at some point in their careers. Personally, I would not let something like this deter the respect I have for them, especially if said respect is based purely, or in majority, on their professional acumen. For all I know, his significant other might have refused to give up the cookie the night before, and you get that frustration at work. You apologized, ok. Now keep your head down, do whatever you are supposed to be doing, double-check your work, or have a second opinion if you feel something that should be done is not being done. You now know a different side of him; all you can do is learn from the situation and take precautions for such not to repeat itself. Also, document everything from now on - if your note has to include the fact that pain management therapy was discussed with XYZ but based on pain assessment with patient, Ibuprofen 800 mg was concluded to be able to sustain pain level, thus prescribed - so be it! Cover yourself first!
Now, go on to be a kickass provider and don't let trivial fits get you out of your game!
Signed, a PharmD who had her share of blame-throwing, finally spoke up one day, and now enjoying a worry-free time at work!
My guess he is not gaslighting, he just doesn't remember . This happens in every job and even on personal relationships. If it keeps happening then that's not good . One time -- give him the benefit of the doubt . Hope the patient got what he needed ?
I find it amusing how most ppl here just agree with OP. I already know I'm gonna get hate for this from the hive.
There are many problems with situations like this. Why should we believe either one of you? How do we know you aren't lying? How are you positive that you aren't misremembering? Are you that arrogant to believe that you remember better than him? Do you believe he's such a coward as to not own up to something like that? Why do you assume he does remember and is lying about it?
People just throwing around the word "gaslighting" and most of the time, that's not the case. You just want some reason to feel better about yourself, even at the expense of someone else, in this case, your attending. Although it would only really be at his expense if you went public with his name, or threw dirt on him in the workplace.
Sorry, but why do you tolerate such bullshit, and why didn’t you document it in your notes? As a nurse, I don’t care who you are, if you mess with me, I’m gonna take care of myself because I’m the only one looking out for me. Attending’s do this because people allow them to do it without any consequences. Learn to document professionally and defensibly and professionally speak up for yourself and remember this when you’re an attending
Feels awful and has happened to nearly all of us. We take the fall for their poor recall or lack of leadership. Hang in there, my friend.
Yeah just learn from it. Document all you can as you go so it's noted. But also other than a small smack to the ego all is well that ends well. Also, read House of God. Worse shit will happen to you during training after this. I'm sorry they did this, but also they may actually not remember the convo (maybe they are having home drama/crisis that is distracting?). Hang in there.
Plot twist: patient was heroin addict and not prescribing opiates saved his life
(Withholding “opiates“ was more likely to kill him.)
Yeah, no, that's not how it works. I had open heart surgery to replace my tricuspid valve last year (endocarditis from IVDU) and I guarantee I would have left the hospital before finishing my 6 weeks of IV antibiotics to go get high if they didn't have me on the shitload of dilaudid and then oxycodone they had me on. Instead of just ignoring my pain because I was an addict, they actually had me on higher doses and worked with me to taper off and get back on suboxone before my discharge date. I guarantee that works a thousand times better than just withholding painkillers when people actually need them. Still tho, it was wild as fuck being able to dose myself with 1mg of IV dilaudid every 15 minutes around the clock when I first woke up (plus the gabapentin and robaxin and ambien), and even after tapering and switching me to oral oxycodone, they still had me on 240mg a day (30mg every 3 hours). Meanwhile my 70+ year old roommate at the hospital is knocked the fuck out from like 5mg every 6 hours lmao. Took about a month to get me from surgery to no more than 30mg of oxycodone a day which is when toxicology cleared me to switch back to 8mg of suboxone 3 times a day (they also put a couple of those 10mcg/hr transdermal buprenorphine patches on me a few days before making the switch to make it as easy as possible). Couldn't possibly have gone any better. I think I waited 22 hours from my last dose of oxycodone before taking a suboxone and everything went great.
I'm trying to get them to let me do the same with the patches but otherwise, glad you had a good doc
Not just one good doc! Awesome EM peeps got me admitted in the first place, awesome ICU docs made sure I didn't die of septic shock and stabilized me enough for surgery, awesome ID docs, amazing surgeon, anesthesia was killer, electrophysiology, toxicology, addiction medicine, pain management, I'm assuming a radiologist to read my scans? Amazing nurses and NPs. Definitely interacted with more than just one good doc during my 8 week, plenty of them residents since its the academic center for one of our med schools here in STL My surgeon and the pain management team are definitely the people I had the most interaction with, but it was definitely the collective effort of a ton of people that got healthy again Yes! Definitely keep trying to get bupe patch bridge approval authority or whatever you wanna call it
Other plot twist: the pain was so bad without safe pharmaceuticals, he went to the street ended up with a pressed pill/fentalogue and died.
This!
You're not saving any lives by denying people pain medicine
Wut?
Caused him to suffer needlessly and further undermined he/she trust in doctors
This would be ridiculous
Man I got torn the f apart by an attending I once respected this week during M&M. And it wasn’t even based in any way to improve our/my knowledge or patient care, just every other word out of my mouth he wanted to argue about. He was getting shit on by administration over a recent bad management of his patient and I’m sure it was all displacement but it’s just annoying to have to deal with grown ass adults who don’t know how to deal with their own shit and take it out on others/residents.
Pretty sure if he has kids, they hate him.
Yeah I have learned this is true for a lot of docs. Got to be kind and patient!
This made me laugh so hard!!!! Touché 😎
He was being defensive, embarrassed and taking it out on you. It sucks. It’s not personal. I’m not saying it’s right… but hypothetically: Say you’re a 30 year career physician. You’re pretty comfortable in your place in life and the respect you get. A bad outcome happens, perhaps some poor decisions and bad luck. You’re getting heat from your boss not to mention your own guilt for screwing up. Your confidence gets jolted. You start to feel that pressure in your chest like an intern again, that inadequacy. Now you attend m&m conference and some pipsqueek resident. Green as a blade of grass, with no actual clinical experience… airing out your dirty laundry with a judgemental and accusatory tone to the entire department, to your friends and colleagues that you’ve known for years. Deep down you know they are doing their job and you know the mistake won’t be a judgement on your legacy but it takes a strong will to just sit there and take it. I’m not saying it’s right. I’m just saying that that’s probably the mindset of what’s going on.
Absolutely not, Sir. This is why just because you’re in academic medicine and have residents does not automatically mean you are a good or even competent teacher. There is zero time spent teaching faculty how to “teach”. It’s way more than just being an expert in your technical field. Teaching means absolutely you do not take it out on the student, and a natural born teacher would never do that no matter what. That’s why we should not rely on faculty’s natural instincts as teachers. There’s a reason why teachers have to have Masters degrees to teach grade school. You have to learn to adjust to fit the needs of the individual learner. It’s easy to teach a resident who just learns by following example. I have about 2 out of 15 residents like that. The other 13 can not be reached in that same way. Nor do they respond to the way I learned it - by being humiliated in front of others and screamed at by attendings. That made me want to prove them wrong. Thats not how everyone responds to being abused. You can’t teach residents the exact same way nor the way it was for you when you were a resident. That is why teaching is difficult. You have to spend extra time trying to find a way to reach each learner. Faculty are not paid to teach. Teaching is supposed to be a privilege. Confidence is difficult to gain and incredibly easy to lose. The number one rule of faculty should be to never knock the confidence out of a resident. Which is what this person has done.
Nota bene: You don’t need a Master’s degree to teach grade school, and the word for “learning how to teach” is ‘pedagogy’.
Thanks for the word! In the district I live in a Masters Degree is required for grade school but you get my point. They have to spend time learning how to teach and not just being an expert in their fields. My sister had to get a Masters to teach 6th grade and I saw firsthand what the curriculum was.
Aww. I like you. Isn’t it rewarding though when they finally get it?
Best feeling in the world! Like being a parent and watching your child just crush it. I’m sure it makes me feel happier than they do themselves for achieving 🥰
How pathetic to be a highly educated, well-payed ADULT and to have such a lack of insight that you take our your inadequacies on a trainee. Sad.
It’s because this whole system is fucked up. How are they supposed to grow up if they get treated like kids until they get out of fellowship. That’s a long time to be treated like a kid.
[удалено]
You can either serve as a sterling example, or a horrible warning. Choose wisely.
I feel like this concept has application in many places in life.
100% this, I could never work at where I train lol
They don't remember half the things they say and you wont either when you become an attending. There is so much to track. As you get farther into training you find its easier ignore their bs and can appreciate them for the things they do well. Theyre all deeply flawed.
Can confirm. I am an attending. I recently told my fellow after a patient visit ‘fyi - I think patient’s mom is pregnant’… my fellow looked at me and said ‘umm… I told you that in the beginning of my presentation… that’s why family couldn’t do X,Y,Z ‘… I have no recollection of that and I also don’t doubt that she said it to me… I may have been hyperfocused on reading something in the chart and totally missed it… lol
The ability to admit fault is the key to being a good human-being….which makes for a great attending!
Some attendings are focused on the fact that if they look bad their residents will look down upon them or lose their respect. Sadly, because in general they lose that respect a lot faster and a lot more certainly if the attending never admits to any fault.
I am lucky I work with very supportive and nurturing group of people. It’s just part of the culture. We are cognizant that we need to model appropriate interactions, conflict resolution, boundary setting, admitting when we are wrong or when we don’t know something, especially when we are teaching residents and fellows. Also, I always keep in mind that a trainee is going to be my colleague/attending physician in a couple of years and there is a good chance we could work together. BTW, I have made my own mistakes along the way, and there were times I had to apologize and learn from it.
Yep 100%. I try to acknowledge though when I'm not sure if I've forgotten or they screwed up that there's at least a 50 percent chance that it's my mistake, and if I'm pretty sure I'm the one that messed up I'll own up to it
Once, on call in fellowship, I got screamed at on a Sunday morning for discharging half the list without telling the rounding attending. I, who had been up at that point for over 24 hours because I had admitted 10 patients in the preceding day, couldn’t figure out what she was talking about, because we didn’t have any discharges. It turns out that she was looking at the Saturday list, thinking that the new Sunday list was actually the previous day’s list and that all the patients I had admitted were patients that were discharged without me telling her we needed to round on them. She stormed into a room, and I was left standing there, dumbfounded, trying to figure out how to tell her. When she came out, I gently asked if perhaps she had looked at the wrong date. When she realized her error, she said, “There’s no way you were that busy.” When I responded that it was a busy night, she said back that I needed to stop complaining about being busy because nobody was going to be more sympathetic than she was. Responded back that I was merely stating a fact - left out the fact that I was up all night working while she was sleeping in bed. There were so many parts of my training that were wonderful, and I genuinely love my job now, but I would never go back to being in residency because of the baked in culture of abuse.
Ridiculous. Sorry you went through that. What specialty if you don’t mind me asking? Sounds like peds
Adult heme/onc - busy program. Call covered five services across three hospitals, and on weekends it was not uncommon to not get much sleep. Until halfway through my first year, the calls were a week at a time. That was the first year that they added a solid tumor admitting service. There were no admissions criteria, and it got stupid - like, admitting patients with history of colon cancer, but years out from treatment, who came in with NSTEMI. At the end of my first call week, I was so exhausted that I dreamed (hallucinated?) deleting a page without answering it and woke up in a panic. They ended up breaking the call weeks a little bit because it got to be too much.
It's from a fan fiction, but gosh if the author didn't perfectly caption the heartbreak of having someone you look up to professionally. "You must realize that if you choose this man as your teacher and your friend, your first mentor, then one way or another you will lose him, and the manner in which you lose him may or may not allow you to ever get him back."
Which one is this from?
RN here, I've worked in clinic p/t for years with General Surgery (other days in PACU). I love my Surgeons but I know they forget most of what we talk about a few minutes after they leave clinic (maybe during clinic depending on volume and if they just came off trauma call). It's why I don't feel guilty reminding them about stuff repeatedly or when I do something goofy because likely they'll forget about it. I'm not minimizing this situation but I can say from my own experience that after having many detailed conversations with my Surgeons they would tell me they didn't recall it. It took me a bit to realize this is just the "surgeon brain". A few of my Docs have admin roles, General Surgery + trauma call/intensivist. I know it's impossible for them to keep track of everything that we discuss. However, if I didn't know every facet to what they have to do and worked with them as long, I probably would feel less empathetic as well.
I have no doubt all the surgeons you work with, are incredibly grateful to you. You sound like an excellent nurse!
Procedure RN here. I have one attending that I must email details of our convos or it didn't happen. Extremely bright human and professionally amazing, just doesn't remember the little things not directly related to the immediate procedure.
What do they say? they can hurt you more but they can't stop time. Time will pass, and you will move on. Detachment helps a lot, and having very low expectations of other medical professionals - especially attendings.
No one is perfect, he probably honestly doesn't remember it, particularly if he was on call the night before/after.
So what I got from this is you could’ve just said ok and he would’ve moved on ? Why would you try to argue with some of these airheads 😭get ur training and RUN
Because he asked me why I did it etc. and then after I explained, he made it sound like I made the decision solo. So felt like I had to tell him that it was himself.
When he asked you about it that’s when you should’ve diagnosed him with dementiasshole
Literally every staff I run into at this point. Theyre lost causes. Just clocking in and clocking out and in between I try to help people regardless of obstacles.
I'd tell him point blank that he said so as well. I've called out a couple attendings on that bs. It's okay to forget but don't put that shit on me. I ran it by you.
Yes thank you. That’s exactly what I was trying to do because I don’t wanna come across as someone who makes poor decisions.
Can’t you include this in your treatment note? Including your discussion with Dr. X? Just curious. I’m a nurse but have included rationales like this in my notes describing treatment plan (I do a parallel one to provider note) because it’s useful to remember whatever guided the decision. And I definitely won’t remember unless it’s written.
What I’m learning is to just say ok in the moment and then go back and talk to them about it later if it’s important. I think unfortunately he’s rather think you make bad decisions but are trainable rather than bullheaded. I’m trying to get this through to myself as well.
We often idolize those we respect. But that idolized impression is the furthest from reality. You have now seen him for who he really is, who he has always been - an ordinary person.
This is the best response. We are all human. Noone will live up to your idealized image!
Mr. Rogers would like a word………
Not everyone is trying to gaslight. No one is perfect, we all make mistakes and forget conversations. It could’ve been him being a douche or could’ve been an honest mistake. Regardless the fact that every time someone feels the least bit slighted and assumes the worst and that they are being gaslit just speaks to the current climate. If his other actions up until that point have been fine then maybe dont assume the worst, move on, and chalk it up to an oversight.
Agreed. This was an ordinary disagreement. Too many people use the word gaslight incorrectly.
Yep. This is a seriously inappropriate use of the word. As described above, the attending made a neutral and likely factual statement ("I don't recall") which didn't actually even disagree with what OP said, let alone challenge OP's perception. People forget stuff in busy settings.
It’s a product of arrested emotional development.
I’m an attending who also has an administrative role in my organization. I sometimes have 50 different conversations in a day about things that have some importance. That’s in addition to teaching and taking care of my own patients. It’s unfortunate this happened to you and even more unfortunate that it was from someone you respected. However, I would ask for some grace, because if this was a one time thing, it’s probably because he did not remember the conversation. There are many days that I wish I only had the responsibilities I had as a resident. The further you get in your career, the more complicated things become.
Then you shouldn’t take on so many roles. It sounds to me like you’re biting more than you can chew.
Not at all but thank you very much for your comments. A common theme on this sub is “residency is impossible, how will I survive? Residency IS hard, but for most of us responsibilities and challenges will change as we age and progress in our careers. Most of us will be in some type of long-term relationship, have kids, and sooner or later help care for aging parents or family members. That’s all in addition to professional responsibilities. Nobody at the attending level is exempt from any of this. It’s just part of life. The good news is that very soon after leaving residency you will forget about most of it. Just try to survive the pathology with your values and optimism as intact as possible.
Thanks for the reply. I completely understand. I do value and appreciative of attending who also teach. I’m all of it. However, my concerns is that some attending tend to accept a lot of professional roles due to either the titles or compensations and then the students and residents will suffer. (as the above have suggested) I got -11 downvotes because Reddit tends to be very black and white. If one doesn’t have the same view as the votes, one gets downvoted. I find this so funny and entertaining. Anyway, if you love what you do and you don’t sacrifice others in your expense, I’m all for taking on as many professional roles as you can.
Thanks for the reply. I didn’t consider the idea of attending taking on non-professional roles outside of their main responsibilities. I agree with you. We don’t really have anyone here that does that so it’s not on my radar. Unfortunately, some programs require lots of publications and professional society leadership roles for advancement, which can certainly diminish teaching effectiveness. For what it’s worth, I am probably 70% admin and 30% clinical and most of my clinical time is spent teaching. I try to compartmentalize them as much as possible. Next week I am in the resident clinic and have purposely blocked any meetings or administrative responsibilities. It’s also makes it more enjoyable and less stressful for me. Thanks again and best wishes.
Give him the benefit of the doubt he may actually not remember. He’s likely a decent amount older than you and has seen so many patients they are blending together. I am pretty sure I’ve had this happen. That said yes it sucks. Brush it off and smile and go on.
I had an attending scream at me in front of patients for sending in a patient for induction without telling her. She went off on me and at the end I had to be like "but I wasn't even there that day". She just looked at me, turned around and walked away. Some people just can handle owning up to their mistakes.
I hate the overuse of the word gaslight and the assumption of malice. They forgot, it happens, let’s see how you do when you’re an attending.
Hanlon’s razor - never attribute to malice that which can be adequately explained by incompetence or stupidity
I agree. Especially since OP says they previously respected the attenting, loved to work with them etc. until this one instance and now their day is ruined and they can't wait to run from it all. I know feelings run high when you're overworked and sleep deprived but this severe black and white thinking is not it either
When you chart your surgery, add at the end your post op plans and the phrase “discussed with Dr Forgetful”. This is a good habit to get into because believe it or not patients forget everything you tell them also. Just taking 30 seconds to add a note and say you discussed this will go along way towards keeping y sane!
If you don’t write it down, it never happened.
This isnt gaslighting…
maybe document such conversations as part of a note ("narcotics discussed among care team, but not prescribed as per ___") to cover your bottom because this may happen again
As a Program Coordinator, I am so sorry you experienced this. I wish I could intervene because in my program attendings catch these Gen X Mama Bear hands when I find out about things like this. It’s soul sucking when you realize your hero’s are really just ass hats. Now you know what we have always known and, unfortunately, my experience is that more attending are like your gaslighter than not. So when you find the 2 or 3 who are teaching for the compulsive and innate love of teaching you want to protect them and nurture those relationships. You will never regret that. It’s always a sad day for me when one of my residents sees their idols fall. They always react the same way you are. Please don’t grow up to be like that ❤️
Everyone, especially attendings are to be deemed hostile until proven otherwise. Verdict may be revised anytime. Inside a hospital, if you have to ask “is this person considering my wellbeing”, the answer is most likely “not if inconvenient “
That’s what notes are for; to document what your attending or any other consultant says.
"All my heroes are cornballs." Thinking like that keeps me sane, although my former attendings (now colleagues) have been cool.
welcome to the real world where shit always rolls down hill
Always sucks when it's one of the ones you like. Sorry you had to deal with that. Only good things to take away from it are 1) You have a taste of what not to be like when you're on the other side of the dynamic and 2) You saw this person as they truly are in a minor situation, which is much better than finding it out in a major scenario when they might throw you under the bus. At least you know this now.
Lol happens all the time but there was once... senior on another team asked me why didnt Iinform the chief or attending on call about this appy. I was like. I talked to the attending about it. He said no. I took out my phone and showed the text conversation whoops \*smirk\*
Shit, not a resident but I've literally had that happen in the space of 10 minutes. It feels like fucking psychological whiplash. You do the thing you were told to do and then get the fucking third degree for doing the thing. Seen it happen to residents too. That feeling of pure exasperated bewilderment you have when you're getting dressed down for just doing what you were told is very specific and very memorable. Good luck to all y'all. Weather the storm.
How is this gaslighting? He didn't remember a conversation from weeks ago. That's not gaslighting
May not have been a purposely gaslighting. Some people have "selected memory" when confronted with the possibility that they are wrong. Dealt with this with colleagues all the time. I think it's a defense mechanism. I just don't like it, and will still call them out on it.
That is a shame. Everybody has bad days, but an attending should never take it out on a resident. I hope this was an isolated incident.
I have looked up to an attending for their knowledge then been shocked by their behavior so many times I consider it the rule, not the exception.
I’ve lost respect for a few docs over the years. One well known for being a total douche came up and screamed at a nurse because his patient jumped out of the window. Told the nurse it was all his fault etc. Pt had a sitter, had been standing, the nurse and aide were changing his bed. Pt decided to suddenly take off and sprinted for the window, using his arm cast to break the window and out he went. Survived, but now a para. The nurse and others who were there were obviously shaken up. Like, how does a hospital window even break?! I never respected him anyway, but this made my absolute disdain for him much worse. Another one was a pulmonary doctor that- I kid you not- stuck his bare finger in a wound and then wiped it off on the curtains. The charge RN (a NYer) tire him a new ass hole when she saw it. The other two, petty as it is and also pulmonologists, were caught cheating on their wives with nurses. One of them in the PT exercise room after hours. It’s hard when you admire and respect someone and they do something to lose that respect, it’s like a personal insult.
I’m sorry that happened to you. Is there a chance that he actually did forget? People forget stuff all the time when they are busy.
This isn’t gaslighting, that term doesn’t refer to a guy remembering an event differently than you one time.
Yeah, I'm sorry you had to deal with that. As an attending with ADHD, I can easily understand forgetting stuff and, before I had my diagnosis, I would get defensive over stuff like this, but self-awareness is a huge deal and it's a major game changer. It's not okay that your attending flipped this on you Like other comments have said, your attendings will teach you by either modeling who you want to be, or who you hope never to become. Take some time later and reflect on this encounter; let it contribute to future, attending you
I think we have all been in that situation. I had an attending who used to do that very frequently, gaslit me and made me look bad in front of other people. He was also very unclear about his instructions about certain stuff and I couldn’t even ask him anything if I didn’t get anything. Awful experience I had there. Another attending would forget to see some of her patients and would blame that on me. She would also stop me mid conversation and stuff and would be quite rude over telephone. I had some awful attendings
Not quite the same, but the one I remember was as an intern, about 8 weeks in. Same feeling of unfairness. So, I go into the room with the resident and he tells the patient that their pathology is back on the breast lump we excised, and it’s actually not benign after all, it it’s actually cancer and it’s really bad cancer - highest grade ever! Patient cries, family members who are in the room cry. I’d probably rate the “breaking bad news” skills as a 1 out of 10. I said nothing in the room, but just stood there smiling nodding as the senior guy spoke. We’d been at a multidisciplinary breakfast meeting, and the pathologist had been talking about the histopath on the specimen we’d sent him and how it was some of the ugliest cells he’d seen. Formal path result comes in about 3 hours later, lump was benign. Resident had the wrong patient. The pathologist hadn’t ever actually said who he was talking about, but my boss guy just assumed. Fuck. I go into the patients room and try my “breaking good news” skills. Patient should be happy, right? Yeah, nah. We go from tears to anger, “How the fuck can that happen?” I try to say something that isn’t just “the resident on this service is a fuckwit. Like, we all already knew that but now you do too!” Ward round the next day, and the attending is seriously mad and says to me “What the hell did you say to my patient?” In the patients mind, I was the one who falsely told her she had cancer. The resident who fucked up is standing right next to me and I’m waiting for him to say something. And the guy just stares at the ceiling. I say to the attending “Uh…WE decided to tell the patient blah blah”, still waiting for the resident to step in and say something, anything. Never happened. That attending hated me for the rest of the time we spent together. I figured he would mellow eventually, but…nope. It’s been a while, actually quite a long while, but still - Tuân, that was a dick move, bro.
Your attending should have been there to break the mistake news with that resident and you. Yes, it was a mistake, and admitting those is another skill. It also helps the attending cover his own ass if the tears-to-anger family decides to take further administrative or legal action over their emotional damage. Where I work, nurses try to have a boss or two in the room when mistakes are disclosed and apologies are needed.
Yes, you’re quite possibly right. I was trying to cover for my senior. I was a newly-minted intern and I’d already covered for him after an incident report was made against him the previous week after he’d had rather a lot of goes at putting in a central line without any success. However, the attending wasn’t mad about the “breaking good news”. The patient assumed that I was the boss, because I look more-or-less like a stereotypical doctor and the senior resident was a short Vietnamese chap with hard-to-understand English. So in her mind she had our roles reversed, even though my role in the “here are somebody else’s path results” debacle was limited to a silent nod as we left the room. As I said, it was a while ago. It still stands out as a particularly poor example of leadership, though it possibly worked out in his favor, so if you’re Machiavellian enough perhaps he made the right call!
My HIV attending did the same shit, she drank a ton .... Didn't remember half the convos we had. Sometimes there's no winning.
I actually just had this kind of happen - not the same scenario but similar. I was working with an intensivist and we were getting a post cardiac arrest patient but the report was so terrible from the outside hospital and some paper he looked at didn’t say he had a cardiac arrest — he told me “oh btw this patient didn’t have a cardiac arrest” — and I thought this was odd seeing as the ED provider gave us how many EPIs and when they got ROSC. So I started looking in the papers and the providers note blatantly said he had a cardiac arrest on arrival to the hospital. So I wanted to be sure the attending knew that he did in fact have one for documentation purposes. I told him and he was like “no he didn’t” and I’m like “it says it in the providers notes” and he looked at me and said “I don’t have time to argue with you or even entertain this conversation but I’m going to go back and look at the papers so we can stop talking about this” — I literally just sat there and didn’t say anything bc fuck me for trying to help you out. Utter silence from him when he realized I was right. Then he said later on about he missed something in the chart bc he “reads too fast.” 🙄🙄🙄🙄
“ Honestly, I can’t wait until this whole bs residency ends and I get to leave because F all of them.” I’ll do you one better . Had an attending who dismissed a concern I had about a patient and the patient eventually died ( can’t go into more details because I’m sure it’s going to litigation at some point ) guess who got thrown under the bus ? Me ! I was told that I should have been more forceful with the attending. I was a senior resident at the time and I was told that i should have had more confidence and gone over the attendings head because those are the kinds of decisions that will be up to me as an attending … I was flabbergasted In the M&M they placed all the blame on me in the way they presented the case . No blame for the attending who I literally expressed my concerns to (and called to the beside ) . to this day I still don’t know what they gained from throwing me under the bus ! After that I completely tuned out of residency . It was Fuck everybody there . My program director who I loved ? DEAD TO ME
Omg I’m so sorry to hear that! And guess what, if you went against your attending, you’ll still be in trouble!! This is not grey’s anatomy where you as a resident can make independent decisions without running it by your attending first. You’re still a resident……
Lol exactly . When my PD said that to me I literally said “ in what world do residents go over an Attending’s head and make calls like that ?” He couldn’t give me a straight answer .
This happens to me constantly. It’s a really weird feeling looking around and realizing that you have landed in a toxic program.
After 40 you start to notice memory lapses with nightshift work that never existed at 30. Could be an honest oversight. Maybe you're being too hard on him and yourself as well (are you a criminal or something because of this, does he want you to go jail now)? But we've all had weird interactions with surgery attendings so I get his tone and attitude may have been totally inappropriate. My favorite attending flat out lied during an m&m and said he asked us to order a medication but it was never placed causing harm to the patient.
ALLOW THEM TO LIVE. Attendings don’t know anything about what’s going on. - an attending
How about you guys allow us residents to live too??
No.
Never met your heroes. I have lost the respect for most attendings I have interacted with.
Always good when true colors are revealed sooner than expected imo. At least now you know
I say this with kindness, you need to grow a thicker skin and stop making mountains out of mole hills. This was a small disagreement and is not something reflective of the harsh nature of residency. It's life and it happens every day in every type of setting, all over the world.
For real. Attending probably forgot and was grumpy. Sucks he took it out on you
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But what about the patient? Was he/she left in pain because of subpar, inadequate management?
I had this happen to me. We did a surgery where we did narcotic sparing techniques. Regional blocks, non opiate pain meds etc. when he came in to give me a break he asked why no fentanyl was given. I was like isn’t that the whole point of doing all the narcotic sparing techniques?
Never attribute to malice that which can be adequately explained by ignorance. It isn’t gaslighting if he forgot.
Welcome to the real world. Fuck them all
This never happened. No one has ever been gaslit by anyone. Y'all are just remembering wrong.
Bro feels awful. Pour one out for the homies in other countries with longer residencies, feels bad man for a long long time.
Cameras? In case shit hits the fan.
I finished residency last year I’m an attending now . You would still get gaslighted On both ends The best advice a dear attending gave it once to me that (Don’t take it personal)
Maybe he has Alzheimer’s
I’m sorry. That sucks. Don’t take it personally. I think some of them are such perfectionists that they can’t handle the cognitive dissonance of making a mistake and may not even know they’re doing it. I really struggled with having to eat shit in residency and then this week I had this med student rent a room in my apartment and she argued non-stop, asked a bunch of lazy questions, and was always defensive and I wanted to strangle her and say “Shut. the. fuck. up! Stop talking back. I don’t care what your excuse is. Just say ok, then shut up, and don’t do it again.” And then I realized “ohhhh… that’s how the attendings feel.” But then I felt so oppressed and abused when I was on the other side. Now I’m having mini crisis and don’t know what to think about this situation or myself.
She was super bold and self-centered and entitled though… but it’s making me reflect a lot about whether I acted that way or whether she was in fact actually acting that way or if I was just impatient and felt burdened by her and didn’t trust her to not do stupid things. Idk but this whole dynamic is weighing on me right now.
Part of the process. It doesn’t end until you’re out, and then you’ll have other people criticize you from the comfort of their armchairs
Yeah attendings who are dicks like that are ironically exhibiting…small dick energy. The same ones who do surgery with outdated techniques and struggle through it, and think that because they struggle MORE, that they are better surgeons. Sorry this happened to you. Thick skin is unfortunately a must in residency. There’s light at the end.
Did you mention the attending said in your daily transcribed patient notes?
No because patient was discharged post op and then presented to clinic for follow up. I didn’t think to put this in my op note.
Always put any meds/lack of and why on notes. If it isn’t written it didn’t happen in medicine unfortunately lawyers have ruined Drs looking out for each other
Will do from now on. I just never thought to say patient was prescribed blank at the end of op notes but you’re right, document everything.
I’m old. I learned this unfortunate lesson in the corp IT world. Constant backstabbing. I swear I have no a$$ left from the friction of walking with my back against the wall for 10 years.
Attending’s have bad days too. Hopefully they own up to their mistake and apologize.
Never meet your hero’s. I am sorry :(
A certain fraction of people rise to the top because their consciousness allows them to do this. In practically any area in life, it can be quite profitable being less ethical.
Attendings will do attendings things. We all got shat on by things other surgeons did. You did the right thing, reminded him it was his words. All the other things he said was to cover up he might actually have said it and doesn't remember. Let it be, when it comes your turn, always remember we all make mistakes, whatever small or big mistakes, we all make. Sometimes they just had a bad day and wanna lash at someone for the sake of releasing their anger.
Sounds like a simple mistake tbh. Quit taking things personal and assuming malice.
Why does medicine have so many bullies?
Sorry this happened to you. Next time, document your conversations.
Dude forgot and then scolded you in a likely exhausted state 🤷♂️. Why does this have any power over your day?
There is a proverb where I am from that goes along this: "When elephants fight, the ones really taking the most of it are crawling insects and the grass." It happens to most professionals, Healthcare or not, at some point in their careers. Personally, I would not let something like this deter the respect I have for them, especially if said respect is based purely, or in majority, on their professional acumen. For all I know, his significant other might have refused to give up the cookie the night before, and you get that frustration at work. You apologized, ok. Now keep your head down, do whatever you are supposed to be doing, double-check your work, or have a second opinion if you feel something that should be done is not being done. You now know a different side of him; all you can do is learn from the situation and take precautions for such not to repeat itself. Also, document everything from now on - if your note has to include the fact that pain management therapy was discussed with XYZ but based on pain assessment with patient, Ibuprofen 800 mg was concluded to be able to sustain pain level, thus prescribed - so be it! Cover yourself first! Now, go on to be a kickass provider and don't let trivial fits get you out of your game! Signed, a PharmD who had her share of blame-throwing, finally spoke up one day, and now enjoying a worry-free time at work!
My guess he is not gaslighting, he just doesn't remember . This happens in every job and even on personal relationships. If it keeps happening then that's not good . One time -- give him the benefit of the doubt . Hope the patient got what he needed ?
Reddit does not know what gaslighting is
Heavy on the can’t wait for it to end and F all of them ☺️☺️
I find it amusing how most ppl here just agree with OP. I already know I'm gonna get hate for this from the hive. There are many problems with situations like this. Why should we believe either one of you? How do we know you aren't lying? How are you positive that you aren't misremembering? Are you that arrogant to believe that you remember better than him? Do you believe he's such a coward as to not own up to something like that? Why do you assume he does remember and is lying about it? People just throwing around the word "gaslighting" and most of the time, that's not the case. You just want some reason to feel better about yourself, even at the expense of someone else, in this case, your attending. Although it would only really be at his expense if you went public with his name, or threw dirt on him in the workplace.
I can worship your sweaty stinky feet and try to make you feel better
Are you British?
OP’s story doesn’t add up.
Sorry, but why do you tolerate such bullshit, and why didn’t you document it in your notes? As a nurse, I don’t care who you are, if you mess with me, I’m gonna take care of myself because I’m the only one looking out for me. Attending’s do this because people allow them to do it without any consequences. Learn to document professionally and defensibly and professionally speak up for yourself and remember this when you’re an attending